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core0

core0

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Reputation Activity by core0

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Like 8

  1. Like
    core0 got a reaction from Dodongo, APRN, NP in Ok TEXAS NP's, wake up and smell the coffee!!!   
    You have a dramatic misunderstanding of what happens in medicine and are missing the entire point of this rule. 
    1. The rule does not say a radiologist must read the xray simply a physician. So a Family practice physician who has minimal training in xray can read and interpret an Xray but an FNP cannot. If the regulation said only a radiologist can read and interpret a radiological study then I would agree. But it doesn't its simply an anti competitive measure to try to ensure physician primacy. 
    2. The road to hell is paved with good intentions. This is especially obvious in an acute care setting. Specifically:
     The problem is with number 2. If I look at an xray and see a problem such as a pneumothorax, I can't act on it until its read by a physician. Even in an tertiary care hospital it regularly takes several hours to get reads on x rays. I can't imagine what its like in a tertiary hospital. For example, I'm asked to look at a KUB for feeding tube placement. I notice that not only is the feeding tube in the lung but there is a pneumothorax on the same side. I put in a chest tube on that side and get a CXR which shows resolution of the pneumothorax. Three hours later I get a call from radiology that there is a pneumothorax. Just sayin. 
  2. Like
    core0 got a reaction from sirI, MSN, APRN, NP in "A Case of Bad Blood"   
    It can happen to anybody. The hard part is distinguishing it from pulmonary edema or ARDS. In a case like Juan's its more straight forward. When someone has been in the hospital a while it could be PNA >> ARDS. It could be volume overload leading to pulmonary edema. Teasing that out can be difficult. Its really a diagnosis of exclusion. Finally, its more associated with FFP and PLT than blood.
    From a clinical perspective Hgb and crit are basically the same thing. Most of the studies on when to transfuse use Hgb so that's what we use.
  3. Like
    core0 got a reaction from ArmaniX, MSN, APRN in Can't get ACNP job   
    I will add something else. At 2 years without practice is something else you have to think about. Its one thing if someone with years of experience takes a year or so off. But you never practiced after school. If you are given the choice between someone with fresh learning and experience and someone who's learning and experience is two years old who would you choose? I would strongly consider an ANCP residency. Both Piedmont and Emory have a number of NP residencies. Some come with attached jobs and this will address your lack of experience. 
  4. Like
    core0 got a reaction from ArmaniX, MSN, APRN in Can't get ACNP job   
    I will add something else. At 2 years without practice is something else you have to think about. Its one thing if someone with years of experience takes a year or so off. But you never practiced after school. If you are given the choice between someone with fresh learning and experience and someone who's learning and experience is two years old who would you choose? I would strongly consider an ANCP residency. Both Piedmont and Emory have a number of NP residencies. Some come with attached jobs and this will address your lack of experience. 
  5. Like
    core0 got a reaction from ArmaniX, MSN, APRN in Can't get ACNP job   
    I will add something else. At 2 years without practice is something else you have to think about. Its one thing if someone with years of experience takes a year or so off. But you never practiced after school. If you are given the choice between someone with fresh learning and experience and someone who's learning and experience is two years old who would you choose? I would strongly consider an ANCP residency. Both Piedmont and Emory have a number of NP residencies. Some come with attached jobs and this will address your lack of experience. 
  6. Like
    core0 got a reaction from juan de la cruz, MSN, RN, NP in Medical billing and coding for NPs   
    You could also look at this one:
    https://store.sccm.org/SearchResults.aspx?searchterm=integrating&searchoption=ALL
    Although I have an authors bias. 
  7. Like
    core0 got a reaction from RNOTODAY in count sheets   
    That is the scariest thing that I have ever heard. We do huge cases and if we have to wait at the end for the RN and scrub to count we do so. Of course last week we had to take an Xray because we were missing an entire Thompson retractor (someone took it to another case and they forgot to count it out). We still took an X-ray to prove that it wasn't there. If you don't have time you make it. There is no excuse for this. Having done three bring backs as a tech (two for Ray-tecs and one for a clamp) I can't see how you can have this attitude.
    David Carpenter, PA-C
  8. Like
    core0 got a reaction from traumaRUs, MSN, APRN in FNP to PA?   
    I believe you are thinking of the University of North Dakota PA program. This was a MEDEX program primarily for RNs. They have changed the structure and now have two arms one which takes clinically licensed or certified providers with three or more years experience. This arm requires you to apply with a family practice physician as your primary preceptor.
    There were two other dual NP PA programs at Stanford and UC Davis that offered PA and FNP certifications. Stanford no longer offers the NP option and its expected that UC Davis will stop offering the PA option when they change to a DNP program. Actually looking at their web site it looks like the FNP and PA programs are separate programs. Its not clear that you can be dual certified.
    For the OP I see a number of obstacles. That's not to say its impossible, but the odds are certainly against you.
    The primary issue I see is convincing a program director to take you. You have already completed training as an FNP but are unhappy with it. There is a limited number of PA seats so you would have to convince someone to take a chance on you.
    You would have to complete the pre-requisites which involve 1-2 years of coursework. Much of this has time limits such as within the last 5 years. Much of your nursing pre-requisites will not count.
    While some programs do not require medical experience preference goes to applicants with medical experience. Generally time as a student doesn't count. Its unclear if you have worked as an NP. That time would count.
    An approach with a higher element of success would be to do a post grad ACNP program with a program that will provide clinicals in the areas you are interested in. This could be followed by a post graduate course. FNP/ACNP would help see the full spectrum of patients. Some areas such as ortho would still be difficult but possible specially with a residency.
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